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Biomedical subjects

V Balraj

Publications and source records attributed to V Balraj.

18 recordsLinked to original sources
PubMed2006

Solar disinfection of water for diarrhoeal prevention in southern India.

AIMS: To evaluate the efficacy and acceptability of solar irradiation in the prevention of diarrhoeal morbidity in children under 5 years of age, in an urban slum in Vellore, Tamil Nadu. METHODS: A total of 100 children were assigned to receive drinking water that had been subjected to solar disinfection in polyethylene terephthalate bottles. One hundred age and sex matched controls were also selected. Both groups were followed by weekly home visits for a period of six months for any diarrhoeal morbidity. At the end of the follow up period, the acceptability of the intervention was assessed by interviews, questionnaires, and focus group discussions. RESULTS: There was significant reduction in the incidence, duration, and severity of diarrhoea in children receiving solar disinfected water, despite 86% of the children drinking water other than that treated by the intervention. The incidence of diarrhoea in the intervention group was 1.7 per child-year, and among controls 2.7 per child-year, with an incidence rate ratio of 0.64 (95% CI -0.48 to 0.86). The risk of diarrhoea was reduced by 40% by using solar disinfection. In qualitative evaluation of acceptability, most women felt that solar disinfection was a feasible and sustainable method of disinfecting water. CONCLUSIONS: Solar disinfection of water is an inexpensive, effective, and acceptable method of increasing water safety in a resource limited environment, and can significantly decrease diarrhoeal morbidity in children.

Child, Preschool↗
PubMed2005

Geographical information system (GIS) in investigation of an outbreak.

An outbreak of fever in a village in southern India was reported on 1st September, 2001. The first reported case presented with epistaxis and a platelet count of 27000h(1)/mm3. Clinical, laboratory and entomological evidence supported a diagnosis of dengue fever. One third of the village was affected and 3.7 % of the population presented with haemorrhagic symptoms; none were fatal. Five acute cases tested for dengue specific IgM showed that two were positive. The larvae of Aedes aegypti were discovered from domestic water collections in the village. Spatial analysis done with the help of Geographical Information Systems software (GIS) demonstrated a centrifugal spread of cases from the most affected street until it involved the entire village. Spatial analysis revealed that cases occurred in clusters and that these could not have occurred by chance. This was our first experience in producing a geo-referenced map of a village area and in spatial analysis. GIS is a novel and simple tool for outbreak investigations and the spatial analyst adds additional information to the data collected. Control of adult mosquitoes and larvae prevented the outbreak from spreading to an adjacent village.

Adolescent↗
PubMed1998

Disease surveillance at district level: a model for developing countries.

For over a decade we have maintained within a district of 5 million people, a system of prompt reporting of cases of childhood vaccine-preventable diseases, encephalitis, meningitis, hepatitis, and rabies; together with a sentinel laboratory surveillance of cholera, typhoid fever, malaria, HIV infection and antimicrobial-resistance patterns of selected pathogens. The system combined government and private sectors, with every hospital enrolled and participating. Reports were scanned daily on a computer for any clustering of cases. Interventions included investigations, immunisation, antimicrobial treatment, health education, and physical rehabilitation of children with paralysis. All vaccine-preventable diseases have declined markedly, whilst malaria and HIV infections have increased steadily. Annual expense was less than one US cent per head. The reasons for the success and sustainability of this model include simplicity or reporting procedure, low budget, private-sector participation, personal rapport with people in the network, regular feedback of information through a monthly bulletin, and the visible interventions consequent upon reporting. This district-level disease surveillance model is replicable in developing countries for evaluating polio eradication efforts, monitoring immunisation programmes, detecting outbreaks of old or new diseases, and for evaluating control measures.

Adult↗
PubMed1998

Laboratory surveillance of hepatitis C virus infection in England and Wales: 1992 to 1996.

Screening assay for antibody to hepatitis C virus (HCV) became available late in 1990 and their use has subsequently become widespread. Laboratories in England and Wales reported 5232 confirmed HCV infections to the PHLS Communicable Disease Surveillance Centre (CDSC) between 1992 and 1996. Fifty-seven per cent (2976) of reports included risk factor information, 80% of which (2382) identified injecting drug use as the main route of transmission. Thirty-one per cent of reports (1640) included clinical information: 41% (665) were asymptomatic, 57% (938) had symptoms, signs, or biochemical abnormalities of hepatic origin, and 2.2% (37) had non-hepatic conditions. To enhance these data two additional surveys have been undertaken to collect data on all anti-HCV tests performed in public health laboratories. In 1993, a retrospective survey of people tested between 1990 and 1993 revealed that the prevalence of antibody was highest (222/331 [67%]) among injecting drug users and recipients of blood or blood products (189/548 [34%]) and lower among other groups. In a prospective survey of HCV tests performed in transfusion recipients in early 1995, the prevalence of antibody was higher in those transfused before 1985 (11/418 [2.6%]) than in those transfused after 1985 (14/1441 [1.0%]). Reports of confirmed infections are a useful method of monitoring hepatitis C infection but additional data on testing are needed to interpret trends overall and in specific risk groups.

Adolescent↗
PubMed1994

An epidemic of varicella in rural southern India.

In an epidemic of varicella investigated in rural southern India, an overall attack rate of 5.9% was observed. Attack rates were 15.9% among under-fives, 11.1% among school children (5-15 years) and 24% among those 16 years and more. None of the persons in the older age groups (16 years or more) suffered from severe forms of the illness or died. Among the 292 cases, three children (3,3 and 5 years of age) died (1% mortality). Their deaths were unusual since they occurred during convalescence from the illness, all three occurred at night during sleep, and all were girls. In the absence of a history suggestive of any known complication of varicella, hypoglycaemia following varicella as the cause of death is hypothesized. It is suggested that death following varicella among children may be more common in India than earlier believed while deaths or severe complications among adults may be rarer than in other countries.

Adolescent↗
PubMed1993

Factors affecting immunization coverage levels in a district of India.

Immunization coverage is measured to assess the performance of the Expanded Programme on Immunization. In 1988 we conducted a coverage survey among 12-23 month-old children in the North Arcot District (population 5,007,746) in southern India. In each of the 12 towns a 30-cluster sample survey was conducted. In the 35 rural blocks with 1590 panchayats, 159 were selected systematically and all children (n = 7300) were surveyed. In the towns, coverage ranged for measles vaccine from 29 to 53%, BCG from 65 to 91% and OPV and DPT third dose from just over 60% to just over 80%. In the rural areas, coverage ranged for measles vaccine from 10.8 to 19.3%, BCG 25.1-34.1%, DPT third dose 42.2-50.4% and OPV third dose 39.6-48%. In the towns, 25, 66, 67 and 59% of BCG, DPT, OPV and measles vaccines had been provided by private agencies showing that availability of vaccines throughout the week and easy access even in payment terms played an important role in achieving higher levels of coverage compared with rural areas where all vaccines are given by Government agencies, free of charge. In the rural areas, significantly large variations in coverage were seen among panchayats--large and peri-urban panchayats had significantly better coverage than small and more rural panchayats. Within any given block (the population unit consisting of 30-40 panchayats served by a Primary Health Centre), there were large variations in the levels of immunization coverage between panchayats.(ABSTRACT TRUNCATED AT 250 WORDS)

BCG Vaccine↗
PubMed1990

Efficacy of oral poliovirus vaccine in rural communities of North Arcot District, India.

The protective efficacy of three doses of oral poliovirus vaccine (OPV) was measured in children under five in the rural blocks of North Arcot District. In 1988, a sample survey of 7% of the total population of the district (population five million) was conducted to determine the immunization coverage with OPV and the incidence of paralytic poliomyelitis in under-fives in the previous 12 months, (n = 42,045). For every case of poliomyelitis, all children matched for exact age in months resident within the same block were taken as controls. Some 67 children had poliomyelitis (prevalence of lameness 1.59/1000, estimated annual incidence 2.57/1000 under-fives). Among cases and controls 24 and 42%, respectively, had received three doses of OPV, while 44 and 33% had received none. In a case-control analysis, the vaccine efficacy (VE) was 62% for all under-fives; for the 12-23 months age group it was 71.4%. For a vaccine with the potential of near 100% VE, this is disappointingly low. Obviously, not only the immunization coverage level, but also the VE should be enhanced if poliomyelitis is to be controlled in India. This may be achieved by a five-dose OPV schedule, annual OPV immunization campaigns in addition to the routine three-dose schedule or by using inactivated poliovirus vaccine of enhanced potency.

Case-Control Studies↗
PubMed1990

Sterilization of syringes and needles for immunization programmes using a pressure cooker.

Pressure cookers are being widely used for sterilizing equipment in small clinics and hospitals and under 'field conditions' in developing countries, especially in India. In the literature there is no report on testing of pressure cookers (PC) to determine if they sterilize adequately. The use of PC for a 15-min 'holding time' after steam starts to emanate from under the weight is quite satisfactory by standard efficacy testing methods for autoclaves.

Needles↗
PubMed1988

Antibody response of children to measles vaccine mixed with diphtheria-pertussis-tetanus or diphtheria-pertussis-tetanus-poliomyelitis vaccine.

The feasibility of giving measles vaccine mixed with either diphtheria-pertussis-tetanus (DPT) or DPT-poliomyelitis (DPTP) vaccine was investigated to simplify the routine immunization schedule. Children 12 to 18 months of age, due for measles immunization, were given measles vaccine alone or mixed with DPT or DPTP. Their prevaccination and four-weeks postvaccination serum samples were tested for the measles virus hemagglutination-inhibition antibody titer. Although 191 children completed the study, only 160 were initially seronegative. The seroconversion rates and geometric mean antibody titers in children given measles vaccine alone, mixed with DPT, or mixed with DPTP were 98%, 96.3%, and 96.4% and 41, 53, and 53, respectively. Local and systemic reactions were no more frequent in children given the mixture of vaccines than in children given DPTP alone. In summary, injecting measles vaccine mixed with DPT or DPTP did not diminish its immunogenic potency or increase adverse reactions. We believe that freshly mixed measles and DPT or DPTP vaccines can be given together, thus avoiding two separate injections.

Antibodies, Viral↗
PubMed1980

Prevalence of secondary dapsone resistance in Gudiyattam Taluk, the leprosy control area of the Schieffelin Leprosy Research and Training Centre, Karigiri. 1. Preliminary report.

A preliminary study of the prevalence rate of secondary dapsone resistance among leprosy patients in Gudiyattam Taluk, Tamil Nadu, was undertaken. During the period March 1978 to February 1979, there were 1580 lepromatous and borderline lepromatous patients considered to be at risk of developing secondary resistance. Of them, 1431 were examined clinically, and reactivation and/or relapse was found in 114 patients. Of these, 46 had a bacteriological index of 2,000 and more. Skin biopsies were taken from 26 patients for mouse foot pad studies. Resistance to dapsone at the highest drug concentration was found in 22 and partial resistance in two patients. The organisms from two patients were sensitive to dapsone. Twenty patients were not biopsied because they had been absent from treatment for significant periods of time. These patients are now under observation. Prior to this study, nine patients had been confirmed to have dapsone resistance in the control area, and during the present study 24 additional patients with secondary resistance have so far been detected. Thus 33 patients with dapsone resistance among the 1431 patients examined yields a crude prevalence rate of 2.3% in Gudiyattam Taluk.

Dapsone↗
PubMedDate not supplied

An outbreak of anthrax meningoencephalitis.

We report a common-source outbreak of anthrax meningoencephalitis in Chittoor district in Andhra Pradesh, southern India, in October 1990. The source of infection was the carcass of a sheep. Of 5 persons who skinned and cut up its meat for human consumption, 4 developed anthrax meningoencephalitis and one a malignant pustule. Another person who wrapped the meat in a cloth and carried it home on his head developed a malignant pustule on his forehead and also meningoencephalitis. All subjects with anthrax meningoencephalitis died, but the one with only a malignant pustule recovered. A large number of people who cooked or ate the cooked meat of the dead sheep remained well. The medical, public health and veterinary authorities were alerted and sheep, goats and cattle in the locality were immunized with anthrax vaccine. Although rules against consumption of meat of dead animals exist, their violation shows a lack of public awareness. Health education should be undertaken to correct this situation.

Adult↗